DR. WANDA KIETLINSKI (NPI# 1114987542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114987542 |
| Entity Type | Individual |
| Full Name | DR. WANDA KIETLINSKI |
| Credential | DPM |
| Practice Address |
905 Allwood Rd Ste 206 Clifton NJ 07012-1946 |
| Mailing Address |
318 Hayward Pl Wallington NJ 07057-1337 |
| Practice Telephone | 9734588090 |
| Practice Fax Number | 9734588091 |
| Mailing Telephone | 9733650022 |
| Mailing Fax Number | 9733651152 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2013-05-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 02518 | NJ | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 3387208 | 05 |
| Street Address |
905 ALLWOOD RD STE 206 |
| City | CLIFTON |
| State | NJ |
| Zip Code | 07012-1946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699015867 | Wallington Footcare Center, Inc. | Podiatrist | 905 Allwood Rd Ste 206, Clifton, NJ 07012-1946 | 2013-02-25 |
| 1366615742 | Sungeun Kim | Physical Therapist | 905 Allwood Rd Ste 206, Clifton, NJ 07012-1946 | 2008-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528428307 | Sofia Konvitz | Behavioral Analyst | 743 Passaic Ave, Suite 109, Clifton, NJ 07012 | 2016-03-07 |
| 1881065118 | Renita Farkas I | Registered Nurse | 777 Bloomfield Avenue, Clifton, NJ 07012 | 2015-10-13 |
| 1619374402 | Lorraine Brenner | Dentist | 1053 Bloomfield Ave Ste 14, Clifton, NJ 07012 | 2014-11-23 |
| 1861897878 | Melissa Langewisch | General Acute Care Hospital | 3 Englewood Road, Clifton, NJ 07012 | 2014-11-03 |
| 1043637192 | Fadwa Sumrein | Internal Medicine | 2 Brighton Rd Ste 400, Clifton, NJ 07012 | 2014-03-26 |
| 1386067841 | Rita Mary Grazulis | Dentist | 91 Nugent Drive, Clifton, NJ 07012 | 2014-02-03 |
| 1366721573 | John P Castronova | Dentist | 79 Ave U, Brooklyn, NJ 07012 | 2011-08-05 |
| 1477849164 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 550 Allwood Rd, Clifton, NJ 07012 | 2011-06-22 |
| 1487805784 | Dron Gauchan | Internal Medicine | 74a Richfield Ct, Clifton, NJ 07012 | 2008-10-05 |
| 1497930283 | Coreen Christie | Counselor | 777 Bloomfiled Ave, Suite B, Clifton, NJ 07012 | 2007-12-31 |
| Find all providers in zip 07012 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205908837 | Martin Peter Conserva | Podiatrist | 730 Clifton Avenue, Clifton, NJ 07013 | 2006-11-15 |
| 1093825861 | Jeffrey Miller | Podiatrist | 1117 Route 46 Suite 203, Clifton, NJ 07013-2450 | 2006-08-30 |
| 1538276506 | Loren Jesse Schneider | Podiatrist | 341 South Parkway, Clifton, NJ 07014 | 2006-08-24 |
| 1346270246 | Ankle & Foot Associates of North Jersey | Podiatrist | 152 Lakeview Ave, Clifton, NJ 07011 | 2006-07-04 |
| 1699015867 | Wallington Footcare Center, Inc. | Podiatrist | 905 Allwood Rd Ste 206, Clifton, NJ 07012-1946 | 2013-02-25 |
| 1649426362 | Haro Podiatry Center PC | Podiatrist | 1005 Clifton Ave, Clifton, NJ 07013-3520 | 2008-08-13 |
| 1366580623 | Thomas A. Graziano Dpm | Podiatrist | 1033 Clifton Ave, Clifton, NJ 07013-3517 | 2007-02-01 |
| 1083708523 | Ibrahim Haro | Podiatrist | 1005 Clifton Ave, 105, Clifton, NJ 07013 | 2006-10-02 |
| 1073622684 | Scott M Raboy | Podiatrist | 1081 Paulison Ave, Clifton, NJ 07011-3627 | 2006-08-29 |
| 1164537767 | Lynda A Sheridan | Podiatrist | 1033 Clifton Ave, Clifton, NJ 07013 | 2006-08-21 |
| Find all providers in CLIFTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.